Provider Demographics
NPI:1912389776
Name:RALEY, SUSANNA SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSANNA
Middle Name:SCOTT
Last Name:RALEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUSANNA
Other - Middle Name:SCOTT
Other - Last Name:TUBBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 21007
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35813-5007
Mailing Address - Country:US
Mailing Address - Phone:256-801-6049
Mailing Address - Fax:256-801-6218
Practice Address - Street 1:401 LOWELL DR SE STE 1&5
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3748
Practice Address - Country:US
Practice Address - Phone:256-265-4462
Practice Address - Fax:256-265-4463
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7587207V00000X
AL44735207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology